Knowledge, attitude, and practice of mothers regarding immunization.

Sir,

Vaccinating the children is a cost-effective method to prevent communicable diseases and improve the survival of children. Government is implementing different strategies for full coverage of immunization. In Chandigarh, the status of immunization coverage among children of nonmigratory population showed that most of the children (73%) were partially immunized, 23% were fully immunized, and only 3% were not immunized, whereas among the migratory population, most of the children (91%) were partially immunized, only 3% were fully immunized, and 6% were unimmunized.[1] To improve immunization coverage, it is important to study the knowledge and attitude of people regarding vaccination. Hence, the present study was conducted with the objective to assess knowledge, attitude, and practices regarding vaccination among women having under-5 children.

A descriptive study was conducted on 173 women having under-5 children residing in Daddu Majra Colony, Chandigarh, selected by systematic random sampling technique (every 7th house). Ethical clearance was obtained from the Ethics Committee of NINE, PGIMER, Chandigarh. Data were collected by interviewing women as per the interview schedule comprised (a) sociodemographic data and (b) knowledge, attitude, and practice regarding immunization of under-5 children after obtaining informed written consent. After the interview, the mother was asked to give the immunization card of the child, and immunization status was crosschecked from the card. Attitude assessment scale had 12 statements (six positive, six negative scored from 1 to 5 total 30 scores), score 12–28 classified as negative attitude, 29–43 neutral attitude, and 44–60 positive attitude.

The women were in the age range of 21–35 years with the mean age 25.95 ± 10.29 years. Nearly half of them studied up to middle (22.5%) or high school (27.5%). Most of them (85.3%) were homemakers and their monthly per capita income ranged from Rs. 3000 to 6000 with a mean of Rs. 4375 ± 2224.71. Male children (54.3%) outnumbered females (45 7%). Age of children ranged from 0 to 1 year (20.8%), 1–2 years (21%–4%), 2–3 years (21.9%), 3–4 years (21.9%), and 4–5 years (9.9%).

Knowledge, attitude, and practices of women regarding vaccinating under-5 children: All the women had heard about vaccination either from dispensary/hospital (80.7%) or from TV (19.3%). Majority of them (98.2%) knew that vaccination should be given to children, 78.5% of mothers knew that after getting vaccination, the child would be free from diseases, i.e., polio/TB/fever/vomiting. Most of the women (95.7%) knew that child gets vaccinated for the first time at birth, although most of them did not know which vaccine is given for which disease. Women had knowledge about polio (75.7%), tuberculosis (41.2%), measles (18.4%), and chickenpox (1.9%) for which a child is vaccinated. The rest of the mothers did not know the names of vaccines and diseases for which it is given. Most of the children (98.8%) received all the vaccination in time except two who received vaccination late [Table 1].

Table 1

Knowledge and practice of women regarding vaccination of under-5 children (n=173)

Age and vaccine	Knowledge of mother regarding vaccine	Number of eligible children for vaccination	Timely given, n (%)	Late given, n (%)
Birth
BCG	67 (41.2)	173	173 (100)	-
OPV	120 (75.7)	173	173 (100)	-
Hepatitis B	31 (19.1)	173	173 (100)	-
6 weeks
OPV-1	120 (75.7)	171	171 (100)	-
DPT-1, hepatitis B-1/penta-1	5 (3.10)	171	171 (100)	-
IPV-1	30 (18.4)	171	171 (100)	-
Rota vaccine*	1 (0.60)	171	1 (0.6)	-
10 weeks
OPV-2	120 (75.7)	169	167 (98.8)	2 (1.2)
DPT 2, hepatitis B 2/penta-2	5 (3.10)	169	167 (98.8)	2 (1.2)
Rota vaccine*	1 (0.60)	169	1 (0.5)	-
14 weeks
OPV-3	120 (75.7)	169	169 (100)	-
DPT 3, hepatitis B-3/penta-3	5 (3.10)	169	169 (100)	-
IPV 2	30 (18.4)	169	169 (100)	-
Rota vaccine*	1 (0.60)	169	1 (0.5)	-
9 months				-
Vitamin-A1	120 (75.7)	159	159 (100)	-
Measles/MR	30 (18.4)	159	159 (100)	-
16-24 months
DPT booster-1	5 (3.10)	137	136 (99.2)	-
OPV booster	120 (75.7)	137	136 (99.2)	1 (0.8)
Measles 2/MR-2	30 (18.4)	137	136 (99.2)	1 (0.8)
Vitamin A-2 (second-ninth dose)	120 (75.7)	137	136 (99.2)	1 (0.8)
5-6 years
DPT booster-2	5 (3.10)	137	137 (100)	1 (0.8)

*Purchased. BCG=Bacillus Calmette Guerin, OPV=Oral polio vaccine, DPT=Diphtheria, pertussis and tetanus, IPV=Inactivated poliovirus vaccine, MR=Measles and rubella

Out of 173 children, after vaccination, main complaints were fever (37%), swelling at the site of injection (13.3%), and pain (0.8%). The fever was managed with syrup crocin (20.2%), tablet PCM (8.6%), or tepid sponging (4.6%). For the management of swelling, ice was rubbed at the site of injection in 10 (5.8%) children, and oil massaging was done in 13 (7.5%) children. Most of the mothers, i.e., 155 (95.1%), had immunization cards with them. Condition of most of (93.8%) cards was in good condition. Entries of all the available cards (95.1%) were complete, most of the mothers (96.6%) had positive attitude regarding vaccination and very few mothers (3.06%) had neutral response.

As per “District level household and facility survey” (DLHS-3), 73% of children were given BCG vaccine, three doses of DPT, and three doses of polio (excluding at birth dose of polio) and measles, whereas at the time of DLHS-4, 85.8% of children were reported immunized with BCG vaccine, three doses of DPT, and three doses of polio (excluding at birth dose of polio) and measles. The coverage of vaccination was more in rural area (87.1%) than that of urban area (85.2%) as per DLHS-4 in Chandigarh.[2]

The present study showed 100% immunization coverage for all vaccines. Almost all the children received vaccination in time. Most of the children were vaccinated at dispensary. Only one mother had purchased Rota vaccine from outside on doctor's recommendation, whereas a study conducted in urban slums of Ahmadabad city among 138 children aged 12–23 months showed 83.3% coverage for BCG, DPT-1, and OPV-1 and 71.7% for measles vaccine.[3]

A study conducted at Primary Health Center, Pondicherry, showed that about 53% of mothers had moderate knowledge, 37.34% had inadequate knowledge, and 9.34% showed adequate knowledge regarding immunization.[4]

The success of any program depends on the attitude of community. The attitude of mothers regarding vaccination in the present study revealed that most of the mothers (95.6%) had a positive attitude regarding immunization. This is the reason for 100% immunization coverage. These results were similar to the study conducted in rural area of Bangalore which showed that 85.4% mothers had positive attitude regarding immunization.[5]

In conclusion, the study showed 100% immunization coverage of under-5 children. Such commendable coverage was due to the excellent service of health professionals including vaccination awareness sessions.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.